Wong Julia, Wong Shirley, Handa Paul, Abbott Carl
School of Nursing, Dalhousie University, 5869 University Avenue, Halifax, Nova Scotia, Canada B3H 3J5.
Blood Press. 2005;14(1):12-20. doi: 10.1080/08037050510008797.
Observational and interventional studies that evaluate the impact of hormone replacement therapy (HRT) on cardiovascular changes have produced inconsistent and inconclusive results. The present study sought to elucidate the influence of HRT on aortic distensibility, left ventricular mass (LVM) and 24-h blood pressure (BP) profile in 38 menopausal women who were either HRT users or non-users. The two groups were similar for age, ambulatory BP, aortic distensibility, cardiac mass, lipid profile and body mass index but differed in clinic diastolic BP (DBP). HRT non-dippers had significantly lower clinic and daytime DBP and a smaller nocturnal BP reduction than dippers. Daytime DBP was significantly and inversely related to duration of HRT use. The present study demonstrates that hormonal therapy after menopause lowers DBP, but shows no significant influence on aortic distensibility, cardiac mass or 24-h BP profile. HRT users who were dippers demonstrated a significantly greater nocturnal BP reduction. Long-term controlled trails are needed to better define the effects of estrogen and progestin on the aorta, the heart and 24-h BP profile in normotensive and hypertensive menopausal women.
评估激素替代疗法（HRT）对心血管变化影响的观察性和干预性研究得出了不一致且无定论的结果。本研究旨在阐明HRT对38名绝经后女性（包括HRT使用者和非使用者）的主动脉扩张性、左心室质量（LVM）和24小时血压（BP）情况的影响。两组在年龄、动态血压、主动脉扩张性、心脏质量、血脂谱和体重指数方面相似，但诊所舒张压（DBP）不同。HRT非勺型血压者的诊所和日间DBP显著更低，夜间血压降幅比勺型血压者更小。日间DBP与HRT使用时长显著负相关。本研究表明，绝经后激素治疗可降低DBP，但对主动脉扩张性、心脏质量或24小时血压情况无显著影响。勺型血压的HRT使用者夜间血压降幅显著更大。需要长期对照试验来更好地确定雌激素和孕激素对血压正常和高血压绝经后女性的主动脉、心脏及24小时血压情况的影响。
